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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s Medicaid Work Requirements: Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

understanding medicaid

Medicaid Financing

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term care. This brief examines key questions about Medicaid financing and how it works.

Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

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  • Implementing the ACA’s Medicaid-Related Health Reform Provisions After the Supreme Court’s Decision

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The practical effect of the Court's decision makes the Medicaid expansion optional for states. This brief addresses questions…

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • Health Coverage and Access Challenges for Low-Income Women

    Issue Brief

    This issue brief examines low-income women’s health insurance coverage, experience with health plans and providers, and access to care. The analysis is based on data from the 2001 Kaiser Women’s Health Survey, a nationally representative survey of nearly 4,000 women between the ages of 18 and 64. Issue Brief (.pdf)

  • State Financing of the Medicare Drug Benefit:  New Data on the “Clawback”

    Issue Brief

    State Financing of the Medicare Drug Benefit: New Data on the "Clawback" Beginning in 2006, states will be obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Issue Brief (.pdf)

  • Overview of Medicaid Managed Care Provisions in the Balanced Budget Act of 1997

    Other Post

    11. Implications For Safety Net Providers Medicaid's transition from fee-for-service to managed care has enormous implications for safety net providers - those hospitals and clinics that deliver basic health care to large numbers of the uninsured. Medicaid has been a major revenue source for many of these providers, because it has reimbursed for the care and services they deliver to low-income patients who, without Medicaid coverage, generally would have no other source of payment. The…

  • Medicaid Managed Care for Persons with Disabilities: A Closer Look

    Report

    This report, Medicaid Managed Care for Persons with Disabilities: A Closer Look, presents an overview of the findings and summarizes the results of the case studies of Medicaid managed care programs that enroll persons with disabilities in four states: Florida, Kentucky, Michigan, and New Mexico. This report also draws from the findings of the 1998 national survey of state practices (Publication #2114) and focus groups of low-income disabled individuals (Publication #2152). This report addresses the…

  • Comparison of Medi-Cal and Healthy Families Programs for Children in California

    Report

    A new side-by-side examination of California's Medicaid program (Medi-Cal) and CHIP program (Healthy Families) shows how these two low-income health coverage programs differ in structure, eligibility, enrollment process, service delivery and scope. This California case study helps to illustrate differences between Medicaid and CHIP. SIDE-BY-SIDE Download

  • Medicaid Enrollment in 50 States: June 1997 to December 1999

    Report

    This report provides current national and state-level data on the number of persons enrolled in Medicaid and CHIP. In addition to identifying recent trends in Medicaid and CHIP enrollment, this report also examines trends in the various eligibility categories within Medicaid. The report reveals that enrollment in Medicaid increased by 1.1 million individuals, or 3.6 percent, in December 1999 compared to the previous December. Executive Summary Report Link to December 2001 Data Update

  • Issues Facing Medicaid and CHIP

    Event Date:
    Event

    Cindy Mann, senior fellow of the Commission, testified to the Senate Subcommittee on Public Health of the Health, Education, Labor and Pensions Committee on how to sustain and expand health care coverage for low-income children and families, and disabled and elderly people in these challenging times. TESTIMONY Download

  • A Medicare Buy-In for the Near Elderly: Design Issues and Potential Effects on Coverage

    Report

    This report examines a Medicare-based approach to reducing the ranks of the uninsured that would permit early retirees between the ages of 62 and 65 to purchase coverage under Medicare. The paper begins with an overview of the challenges of insuring the near-elderly and explores the potential effects of a Medicare buy-in on coverage of this population. The authors conclude that, unless premiums for such coverage were low or tied to enrollees' income, this approach…